Abstract：
OBJECTIVE: To investigate changes in postoperative mobility status in patients with ASD, and the determining factors that influence these changes and their impact on clinical outcomes, including the rate of home discharge and long-term mobility.
METHODS: A total of 299 patients with ASD who underwent multi-segment posterior spinal fusion were registered in a multi-center database were investigated. Patient mobility status was assessed using walking aids and classified into five levels (1: independent, 2: cane, 3: walker, 4: assisted, and 5: wheelchair) preoperatively, at discharge, and after 2 years. We determined improvements or declines in the patient\'s mobility based on changes in the classification levels. The analysis focused on the factors contributing to the deterioration of postoperative mobility.
RESULTS: Two years postoperatively, 87% of patients maintained or improved mobility. However, 27% showed decreased mobility status at discharge, associated with a lower rate of home discharge (49% vs. 80% in the maintained mobility group) and limited improvement in mobility status (35% vs. 5%) after 2 years. Notably, postoperative increases in thoracic kyphosis (7.0 ± 12.1 vs. 2.0 ± 12.4°, p = 0.002) and lower lumbar lordosis (4.2 ± 13.1 vs. 1.8 ± 12.6°, p = 0.050) were substantial factors in mobility decline.
CONCLUSIONS: Postoperative mobility often temporarily decreases but generally improves after 2 years. However, an overcorrection in sagittal alignment, evidenced by increased TK, could detrimentally affect patients\' mobility status. Transient mobility decline associated with overcorrection may require further rehabilitation or hospitalization. Further studies are required to determine the biomechanical effects of surgical correction on mobility.
METHODS: A total of 299 patients with ASD who underwent multi-segment posterior spinal fusion were registered in a multi-center database were investigated. Patient mobility status was assessed using walking aids and classified into five levels (1: independent, 2: cane, 3: walker, 4: assisted, and 5: wheelchair) preoperatively, at discharge, and after 2 years. We determined improvements or declines in the patient\'s mobility based on changes in the classification levels. The analysis focused on the factors contributing to the deterioration of postoperative mobility.
RESULTS: Two years postoperatively, 87% of patients maintained or improved mobility. However, 27% showed decreased mobility status at discharge, associated with a lower rate of home discharge (49% vs. 80% in the maintained mobility group) and limited improvement in mobility status (35% vs. 5%) after 2 years. Notably, postoperative increases in thoracic kyphosis (7.0 ± 12.1 vs. 2.0 ± 12.4°, p = 0.002) and lower lumbar lordosis (4.2 ± 13.1 vs. 1.8 ± 12.6°, p = 0.050) were substantial factors in mobility decline.
CONCLUSIONS: Postoperative mobility often temporarily decreases but generally improves after 2 years. However, an overcorrection in sagittal alignment, evidenced by increased TK, could detrimentally affect patients\' mobility status. Transient mobility decline associated with overcorrection may require further rehabilitation or hospitalization. Further studies are required to determine the biomechanical effects of surgical correction on mobility.
摘要：
目的：研究ASD患者术后活动状态的变化，以及影响这些变化的决定性因素及其对临床结果的影响，包括家庭出院率和长期流动性。
方法：在多中心数据库中登记了299例接受多节段脊柱后路融合术的ASD患者。使用助行器评估患者的活动状况，并将其分为五个级别(1：独立，2：甘蔗，3:沃克,4：协助，和5：轮椅）术前，在放电时，两年后。我们根据分类水平的变化确定患者活动能力的改善或下降。分析的重点是导致术后活动能力恶化的因素。
结果：术后两年，87%的患者保持或改善了活动能力。然而,27％的人在出院时表现出降低的移动性状态，与较低的家庭出院率相关(49%与维持流动性组中的80%)和流动性状况的有限改善(35%与5%)后2年。值得注意的是,胸椎后凸的术后增加（7.0±12.1vs.2.0±12.4°,p=0.002）和下腰椎前凸（4.2±13.1vs.1.8±12.6°,p=0.050）是流动性下降的重要因素。
结论：术后活动度通常会暂时降低，但一般在2年后改善。然而,矢状对齐中的过度校正，传统知识的增加证明，可能会对患者的行动状况产生不利影响。与过度矫正相关的暂时性活动能力下降可能需要进一步康复或住院治疗。需要进一步的研究来确定手术矫正对活动性的生物力学影响。
方法：在多中心数据库中登记了299例接受多节段脊柱后路融合术的ASD患者。使用助行器评估患者的活动状况，并将其分为五个级别(1：独立，2：甘蔗，3:沃克,4：协助，和5：轮椅）术前，在放电时，两年后。我们根据分类水平的变化确定患者活动能力的改善或下降。分析的重点是导致术后活动能力恶化的因素。
结果：术后两年，87%的患者保持或改善了活动能力。然而,27％的人在出院时表现出降低的移动性状态，与较低的家庭出院率相关(49%与维持流动性组中的80%)和流动性状况的有限改善(35%与5%)后2年。值得注意的是,胸椎后凸的术后增加（7.0±12.1vs.2.0±12.4°,p=0.002）和下腰椎前凸（4.2±13.1vs.1.8±12.6°,p=0.050）是流动性下降的重要因素。
结论：术后活动度通常会暂时降低，但一般在2年后改善。然而,矢状对齐中的过度校正，传统知识的增加证明，可能会对患者的行动状况产生不利影响。与过度矫正相关的暂时性活动能力下降可能需要进一步康复或住院治疗。需要进一步的研究来确定手术矫正对活动性的生物力学影响。
